title: [Urinary ascites, uroperitoneum and urinary peritonitis in children: management of nine case reports in Madagascar].
abstract: OBJECTIVE
  To evaluate the frequency of urinary peritonitis in children and to highlight its terms of management in a country with limited resources.
  
  
  METHODS
  We retrospectively observed nine case reports of urinary peritonitis collected in surgical reanimation service at the CHU of Antananarivo, from 1st January 2009 to 31 December 2012.
  
  
  RESULTS
  Urinary peritonitis accounts 0.5% of all pediatric abdominal emergencies and 5% of pediatric urological emergencies collected in our service during study period. Three etiologies were traumatic bladder rupture, one bladder iatrogenic rupture, four secondary to obstructive uropathy and one other after cystolithotomy. We found a new case of posttraumatic transverse rupture of the bladder neck. Among obstructive uropathy observed, there were two cases of posterior urethral valves and two cases of ureteralpelvic junction obstruction. Clinical expression was dominated by fever, with abdominal distention and defense. In majority of cases, etiological diagnosis was made intraoperatively. The surgical treatment by laparotomy was performed under cover of systemic antibiotic therapy. Evolution was complicated with sepsis in three cases and acute renal failure in both cases. Surgical follow-up without complication were observed in four cases. A child has died to septic shock and multivisceral failure.
  
  
  CONCLUSIONS
  Unlike urinary ascites resulting a transperitoneal extravasation of urine, uroperitoneum was a fistula between adominal cavity and content of the urinary tract. Urinary ascites was a rare cause of peritonitis. In contrast, uroperitoneum caused peritonitis quickly. Urinary peritonitis was a rare entity but severe prognosis in children. In majority of cases, etiological diagnosis was made intraoperatively.
authors.affiliation: Unité de soins de formation et de recherche (USFR), service de chirurgie viscérale et vasculaire, CHU Joseph Ravoahangy Andrianavalona (CHU-JRA), BP 4150, Antananarivo, Madagascar. Electronic address: heryfano@yahoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Raherinantenaina
authors.forename: A H
authors.initials: AH
authors.lastname: Rambel
authors.forename: J
authors.initials: J
authors.lastname: Rakotosamimanana
authors.forename: T M A
authors.initials: TM
authors.lastname: Rajaonanahary
authors.forename: T
authors.initials: T
authors.lastname: Rajaonera
authors.forename: F A
authors.initials: FA
authors.lastname: Rakototiana
authors.forename: F A
authors.initials: FA
authors.lastname: Hunald
authors.forename: M L
authors.initials: ML
authors.lastname: Andriamanarivo
authors.forename: H Y H
authors.initials: HY
authors.lastname: Rantomalala
authors.forename: H N
authors.initials: HN
authors.lastname: Rakoto Ratsimba
mesh_terms: D001201:Ascites / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008270:Madagascar; D008297:Male; D010537:Peritoneum; D010538:Peritonitis / Q000601:surgery*; D012189:Retrospective Studies; D012421:Rupture; D001743:Urinary Bladder; D014556:Urine
keywords: Ascite urinaire; Bladder traumatic rupture; Drainage; Péritonite urinaire; Rupture vésicale traumatique; Urinary ascites; Urinary peritonitis; Urinary tract obstruction; Uropathie obstructive; Uroperitoneum; Uropéritoine